After a crash on Sunday at a car show in Sioux Falls, 47-year-old Lois Two Bulls is charged with second degree manslaughter and driving without a license. Her defense attorney argues that Two Bulls suffers from a seizure disorder, but it has not been determined whether that was a factor in the crash.
Seizures continue to be a puzzle for doctors. Though there are treatments available to reduce the number and, in some cases, the severity of seizures, doctors still cannot predict exactly when or how often they will occur.
According to the Epilepsy Foundation, there are about 20 different kinds of seizures that people around the world have to manage, and for Dr. Sharique Ansari at Sanford Health, it is important to start with a question- what is a seizure?
"Seizure, when they hear seizure, they think of tonic, clonic, or shaking, but that's not usually the case," Dr. Ansari said.
While convulsions can occur with seizures, in order to truly understand the source of a seizure, doctors must look deeper into the brain.
"If it's involving a small area of the brain, which we call it a focal seizure, and the focal is further sub-classified into one that you lose consciousness or some you're totally aware when you're having a seizure," Dr. Ansari said.
Police say Two Bulls told them she doesn't remember the crash.
Knowing when a seizure is coming can be hard to predict.
"An aura is a warning sign. You can have a different type of epigastric or abdominal sensation or, for example, some patients report an unpleasant odor or smell," Dr. Ansari said.
At this point, doctors have no cure for seizure disorders, only a variety of treatments which are individualized for each patient. Some of those treatments, Dr. Ansari says, may actually make the problem worse for some patients.
"There are different factors that contribute, for example, different medication can have an interaction and people without knowing can actually lower their seizure threshold and can have seizures, despite taking medication," Dr. Ansari said.
Because there is no way to accurately predict when a seizure will strike, seizure disorder patients in South Dakota must be seizure free for a minimum of 6 months before they are granted a driver's license.
"If you can lose consciousness while driving behind the wheel, it's certainly dangerous. So, there's a rule of driving restrictions we put on patients with a history of seizures," Dr. Ansari said.
Dr. Ansari says the source of some seizures can be pinpointed with testing and MRIs. It is still unclear whether Two Bulls' defense will focus on her seizure disorder and police have not yet determined whether that was a factor in the crash.
Two Bulls faces charges of second degree manslaughter, not having insurance, and driving without a license.